UNCONTROLLED WHEN PRINTED
Introduction
- Droperidol is a neuroleptic, antipsychotic agent that acts on Alpha and Dopamine receptors, resulting in sedation
- Onset of effect usually 3-5 mins both IM and IV
Indications
- Disturbed and Abnormal Behaviour (Generally RASS 1 ~ 3) where risk to safety is evident
- Dementia or frail patients where Olanzapine cannot be administered or is ineffective
Contraindications
- Known allergy
- Known Parkinson’s Disease
- Where Ketamine has been administered to sedate this episode
- <6 years of age
Precautions / Notes
- Sedation of any patient <16 years of age should prompt a prior ASMA consult wherever practicable.
- IV access in children should not be routine – sound judgement should apply
- IV doses require sound judgement
- Dementia patients – apply caution. Use lower doses
- Organic causes such as suspected sepsis, traumatic brain injury or spontaneous intra-cranial event must be considered unlikely
- ‘Agitated or Excited Delirium’, ‘Acute Behavioural Disturbance’ and ‘Drug Induced Psychosis’ are some alternative terms that may be used by other agencies
- SpO2 and EtCO2 monitoring must be applied whenever level of consciousness drops (~RASS <0)
Management
Adults < 70 years old:
- IM (preferred route):
- 5 - 10mg
- IV:
- 2.5 - 5mg
- Repeat after 15mins if indicated to a total maximum cumulative dose via all routes 20mg/24hrs. Consider switch to IV Midazolam only if necessary after second dose.
Adults > 70 years of age or frail or with dementia:
- IM (preferred route):
- 5mg
- IV:
- 2.5mg
- Repeat after 15mins if indicated to a total maximum cumulative dose via all routes 10mg/24hrs. Consider switch to IV Midazolam only if necessary after second dose.
Paediatrics 6-15 years old:
- IM (preferred route):
- 0.2mg/kg to a maximum of 5mg
- Repeat after 15mins if indicated to a total maximum cumulative dose via all routes 10mg/24hrs.
- IV:
- 0.2mg/kg to a maximum of 5mg
- Repeat after 30mins if indicated to a total maximum cumulative dose via all routes 10mg/24hrs)
Special Considerations
- Extrapyramidal effects / Dyskinesia
- Increased falls risk
- Hypotension
- Apply monitoring as soon as practicable
References
References
Presentation
10mg/2ml (equivalent to 5mg/ml)
DILUTION
IM
- Do NOT dilute
IV / IO
- Dilute 10mg/2ml with 8ml NaCl (equivalent to 1mg/ml)
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